| NPI | 1770901514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0082177) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101262259) |
| 207L00000X Anesthesiology (Licence: CT 66462) | |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2021-07-15 |